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OVARIAN CANCER

The female reproductive system contains two ovaries, one on each side of the uterus. The ovaries produce eggs (ova) as well as the hormones oestrogen and progesterone. Ovarian cancer is a type of cancer that begins in the ovaries

Types of ovarian cancer

The type of cell where the cancer begins determines the type of ovarian cancer you have. Ovarian cancer types include:

Epithelial tumours

They begin in the epitheliums (surface layer of tissue) that covers the outside of the ovaries. About 90 percent of ovarian cancers are epithelial tumours. There are different types of epithelial cancer. They include serous (the most common type), endometroid, mucinous and clear cell.

The different types of epithelial cancer are

  • serous
  • mucinous
  • endometrioid
  • clear cell.
Borderline ovarian tumours

They are not cancer, but abnormal cells that form in the tissue covering the ovary. They are usually found in women ages 20-40. They grown more slowly than cancer cells and very rarely turn into cancer cells. These type of tumours can be cured with surgery.

Germ cell tumours

They begin in the cells in the ovaries that develop into eggs. which begin in the egg-producing cells. These rare ovarian cancers occur in younger women (up to age age 30s) but treatment usually works well for this type and rarely come back. There are two different types of germ cell tumours. They are benign and malignant germ cell ovarian tumours.

Examples of benign germ cell tumours are dermoid cysts or mature teratoma which are more common in women in their child bearing years. Examples of malignant germ cell tumours are immature teratoma, yolk sac tumours, dysgerminomas, polyembryoma, mixed germ cell tumours. 

Symptoms of Ovarian cancer  

Most ovarian cancers are discovered later because they hardly cause symptoms in early stage. Signs of ovarian cancer may include:

  • loss of appetite
  • feeling full quickly when you eat
  • passing urine more often than usual
  • a sudden change in your normal bowel habit (e.g. diarrhoea or constipation)
  • Being bloated all the time
  • exceptional weight gain or weight loss
  • unexplained tiredness (fatigue)
  • feeling pain in the lower tummy area or back
  • sudden vaginal bleeding after your menopause.

Causes/risk factors of ovarian cancer :

There is no direct cause linked to ovarian cancer. However, there are some risk factors that increase the chances of getting them

Age

Although ovarian cancer can occur in younger women. it is common in women between the ages 50 to 60 years.

Inherited genes

A little percentage of ovarian cancers are caused by gene mutations inherited from parents. The genes are called breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2). These genes also increase the risk of breast cancer. Having a mum or sister that has had ovarian cancer can increase the risk of getting ovarian cancer.

Hormone replacement therapy

This can increase the risk of getting ovarian cancer if taken after menopause.

Existing/previous medical conditions

Women who have had breast cancer, diabetes or endometriosis may have a slightly increased risk of getting ovarian cancer

Lifestyle factors

Being obese, and drinking alcohol can increase the risk of certain types of ovarian cancer.

Other factors

Factors like never given birth, starting your period early, having a later menopause, giving birth over the age of 35.

Diagnosis 

Pelvic exam

Your doctor may manually palpate your abdomen to feel for any abnormal masses. If your doctor does, you will be sent for further imaging tests.

Ultrasound scan

Tests such as a transvaginal or abdominal ultrasound will help give a clearer view of your ovaries and pelvis. This will give a clearer indication of the lump in your ovaries.

CA-125 blood test

This is a test that checks for ovarian cancer tumour markers. CA-125 test is a test that can detect a protein that’s often found in ovarian cancer cells

Biopsy

Your doctor may remove a small sample of the lump for testing in a laboratory under a a microscope.

Other imaging tests

Other tests like CT and MRI scans may be used to get 3D and magnetic pictures of the organ sin your pelvis.

Surgery

This might be the only way to be certain of ovarian cancer. This will involve removing the ovary and having it tested for signs of cancer.

Staging of Ovarian cancer

Stage 1

This means that the cancer is in only one ovary or fallopian tube (sage 1A), both ovaries or fallopian tubes (stage 1b), and the cancer is in one or both ovaries with cancer cells on the surface of the ovaries or fallopian tubes, or there are cancer cells in the fluid in the abdomen or pelvis (ascites).

Stage 2

This means the cancer has grown into the womb or fallopian tubes (stage 2A) or into other tissues in the pelvis like the bladder or colon (stage 2B)

Stage 3

This means the cancer has spread into the lymph nodes in the back of the abdomen and the peritoneum (Stage 3A) or there are cancer growths less than 2cm on the peritoneum and lymph nodes (stage 3B) or there are cancer growths more than 2cm on the peritoneum and lymph nodes (stage 3C)

Stage 4

This means the cancer has spread to other body organs such as the liver or lungs. the cancer can cause a build up of fluid in the lining of the lungs (pleural effusion) or inside the liver, lymph nodes outside the abdomen and other organs such as the lungs (stage 4B)

Treatment of Ovarian cancer

Surgery

You may have surgery to remove one ovary if cancer is present in only one ovary (this will not affect future fertility), to remove both ovaries if cancer is present in both ovaries (you may freeze your eggs before this procedure) or to remove both ovaries and uterus, if cancer has spread and you do not want to get pregnant in future.

Chemotherapy

This involves using chemicals to kill cancer growing cells in the body.  It can be used before surgery or used after surgery to kill any cancer cells that might be left over. This and surgery are the main treatments for ovarian cancer.

Radiotherapy

This uses high energy x-rays to kill the ovarian cells. This is not normally used for ovarian cancer but can be used to reduce symptoms of advanced ovarian cancer.

Targeted therapy

These drugs change the way cancer cells work by targeting specific vulnerabilities within them. Your doctor may test your cancer cells to check which targeted therapy is most likely to have an effect on your cancer.

 

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